All on 4 Dental Implants: Step-by-Step Procedure

Key Takeaways

• Only four implants per arch are required to replace all missing teeth.
• Immediate function: patients leave the office with fixed teeth the same day.
• Less invasive: often eliminates the need for bone grafting.
• Cost-effective alternative to full-mouth traditional implants.
• Long-term success can be achieved when combined with proper oral hygiene and regular dental visits.

Dental implants have changed the way dentistry restores missing teeth, offering a permanent solution that looks, feels, and functions like natural teeth.

Among the available options, the All-on-4 dental implant method has become one of the most popular treatments for patients with complete or near-complete tooth loss. It is a streamlined solution that restores a complete smile in a shorter time compared to traditional implants.

What Are All-on-4 Dental Implants?

The All-on-4 technique is designed for people who have lost most or all of their teeth in one or both jaws. Instead of placing 8–10 implants per arch, dentists place just four strategically angled implants to support a fixed full-arch prosthesis.

This approach is:

• Minimally invasive (requires fewer implants and surgeries),
• Faster (immediate teeth on the same day),
• Reliable (high success rates backed by decades of research).

“One of the biggest misconceptions is that implant surgery is very painful. In fact, most patients are pleasantly surprised at how straightforward and tolerable the process is. The precision of modern techniques makes recovery faster than people expect.”
— Dr. Jerry Jesin, DDS

Step-by-Step All-on-4 Dental Implant Procedure

1. Patient Evaluation

Every successful All-on-4 treatment begins with a detailed and personalized patient evaluation. This stage is much more than just “taking X-rays.” It’s a comprehensive diagnostic process that allows the dentist to create a treatment plan tailored to each individual’s anatomy, health, and goals.

• Digital X-rays & CBCT scans – provide detailed 3D images of the jawbone and sinus anatomy.
• Bone density analysis – determines whether bone grafting is necessary (often avoided with All-on-4).
• Oral health review – assessment of gums, remaining teeth, and bite.
• Medical history & lifestyle – conditions like diabetes or smoking habits are considered in planning.

This stage gives patients clarity and confidence. By the end of the evaluation, most patients already know whether they are candidates for All-on-4 and what to expect during the subsequent phases of treatment.

2. Implant Placement Surgery

Once planning is complete, the procedure moves into the surgical stage — the placement of the four implants. For many patients, this is the part they worry about most. Still, in reality, it is usually a comfortable process performed under local anesthesia, often combined with sedation to help patients relax.

Implant Position	Placement Angle	Purpose
Two front implants	Vertical	Provide stability in the strongest bone area
Two back implants	Tilted at 30–45°	Maximize bone support and avoid the sinus or nerve canal.

The procedure usually takes only a few hours per arch. Patients often report that they feel pressure during the placement but not pain. Afterward, some swelling and mild discomfort are normal, but these symptoms are usually manageable with prescribed medication and subside within a few days.

For patients who have had teeth extracted during the same appointment, the implants are often placed immediately into the extraction sites, further reducing treatment time. This combination of efficiency and precision is what makes the surgical phase of All-on-4 such a breakthrough in modern implantology.

3. Immediate Loading – Same-Day Teeth

Perhaps the most exciting aspect of the All-on-4 method is the concept of immediate loading, also known as “Teeth in a Day.” Traditionally, implants required months of healing before any teeth could be attached. With All-on-4, patients leave the dental office on the same day of surgery with a fixed temporary bridge securely attached to their implants.

Benefits for patients:

• Walk out of the clinic with a new set of fixed teeth.
• Immediate ability to smile and speak with confidence.
• No long waiting period with removable dentures.

Patients often describe this stage as life-changing. Instead of waiting months with removable dentures, they wake up from surgery already enjoying the benefits of fixed teeth.

4. Provisional Prosthesis

The temporary bridge, known as the provisional prosthesis, plays a critical role in the overall success of the treatment. While it is not as durable as the final prosthesis, it is carefully designed to:

• Protect the implants during the healing phase,
• Restore function so patients can chew and speak normally,
• Provide a natural-looking smile during recovery.

Dentists typically recommend a soft food diet during this period — foods like mashed potatoes, scrambled eggs, fish, smoothies, and pasta are ideal. Hard, crunchy, or sticky foods should be avoided, as they can put unnecessary stress on the new implants.

The provisional phase also gives patients a chance to “test drive” their new teeth. They can provide feedback on comfort, bite alignment, and aesthetics, which helps the dental team fine-tune the design of the final prosthesis.

As Dr. Rob Eisen, DDS, explains:
“We always tell patients that the temporary bridge is the bridge to success. It protects the implants and gives us valuable insights to make the final prosthesis perfect for each individual.”

5. Healing and Osseointegration

The healing phase is when the fundamental biology of implant dentistry takes place. Over the course of several months, the titanium implants undergo a process called osseointegration, during which they fuse directly with the jawbone. This creates a stable and permanent foundation for the final prosthesis.

The healing period typically lasts 3 to 6 months, though it can vary depending on the patient’s health, bone density, and adherence to post-operative care instructions. During this time, patients may experience minor gum tenderness or changes in bite as the tissues adapt, but these are temporary and closely monitored during follow-up visits.

Key recovery guidelines include:

• Maintaining excellent oral hygiene with a soft-bristled toothbrush and antibacterial rinses,
• avoiding smoking and alcohol (both delay healing and increase the risk of implant failure),
• sticking to a soft-food diet for at least the first few weeks,
• Attending scheduled check-ups so the dentist can monitor progress

By the end of this stage, most patients have become fully adapted to their provisional prosthesis and are ready to proceed to the next and final step: the placement of their permanent teeth.

6. Final Prosthesis Placement

After healing, the temporary bridge is replaced with a permanent custom-made prosthesis.

Types of final prosthesis:

• Acrylic over a titanium frame – durable and cost-effective.
• Porcelain or zirconia bridge – highly aesthetic, long-lasting.

7. Ongoing Follow-Up Care

Regular maintenance is crucial for ensuring long-term success.

Follow-Up Care	Frequency	Purpose
Professional check-ups	Every 6 months	Monitor implant health and gum condition
Professional cleaning	Every 6–12 months	Prevent peri-implant disease
Prosthesis adjustments	As needed	Ensure comfort, fit, and bite stability

All-on-4 vs Traditional Dental Implants

Feature	All-on-4	Traditional Implants
Implants per arch	4	6–10
Bone grafting	Often not required	Frequently required
Treatment time	Same-day teeth	Several months
Cost	Lower overall	Higher (more implants & procedures)
Aesthetics & function	Immediate	Delayed

Ongoing Follow-Up

The journey doesn't end with the placement of the final prosthesis: ongoing follow-up appointments are essential to monitor the health of the implants and make any necessary adjustments. Here's why they matter:

• Routine Appointments: Patients are advised to schedule follow-up meetings with their dental professionals regularly. These appointments serve to evaluate the stability of the implants, assess the condition of the prosthesis, and monitor overall oral health.
• Necessary Adaptations: Over time, it may become essential to make adaptations or refinements to the prosthesis to ensure ongoing comfort and functionality. These visits are a crucial component in ensuring the long-term success of All-on-4 dental implants.

As a whole, the All-on-4 dental implant method offers a streamlined and efficient solution for individuals experiencing extensive tooth loss. This step-by-step implant procedure marks the commencement of a journey toward restoring confidence in your smile and enhancing your overall oral health.

However, when it comes to the question of how dental implants are performed, it’s essential to keep in mind that each patient's circumstances are unique, emphasizing the importance of personalized care to achieve the best outcomes in the implant procedure steps.

Ready to take the next step towards a healthier and more confident smile? Contact us at North York Smile Centre, where we stand as your trusted partner in All-on-4 dental implant steps.

Our experienced team is here to guide you through the process and provide the highest quality care. Schedule your consultation today and discover the life-changing benefits of dental implants, including the All-on-4 prosthesis steps. Don't wait any longer: your new smile awaits!

Frequently Asked Questions

1. How long do All-on-4 dental implants last?

With proper care, implants can last a lifetime. The prosthesis itself may need replacement after 10–15 years due to wear and tear.

2. Is the procedure painful?

Most patients report minimal discomfort. Sedation and anesthesia make the process comfortable.

3. What is the difference between All-on-4 and All-on-6?

All-on-6 uses six implants per arch for added stability, usually recommended for patients with good bone density.

4. Can smokers get All-on-4?

Yes, but smoking increases the risk of implant failure. Quitting or reducing smoking greatly improves outcomes.

5. How soon can I eat after surgery?

You can eat soft foods immediately with the provisional prosthesis. Crunchy and hard foods should be avoided until the final healing stage.